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Quick reference guide for CPT codes for Lumbosacral Spine procedures.

1 Official Description Common Description Procedure Codes Possible Additional Codes Explanations Work RVU Total RVU
ADR, Lumbar Artificial Disc Placement   22857     22857 - 27.13 22857 - 51.43
2 ALIF 1 Level + ADR 1 Level - COMPLETE TREATMENT PLAN   22558; 22857; +22845; +22853; +20930   22558 - anterior lumbar interbody fusion; 22857 - lumbar artificial disc replacement; +22845 - anterior plating if used, do not use for standalone; +22853 - placement of intervertebral device such as PEEK, titanium, use for stand-alone cage with screw or wing fixation, do not use for structural bone allograft, instead use +20931; +20930 - morselized allograft

22558 - 23.53; 

22857 - 27.13;

+22845 - 11.94;

+22853 - 4.25;

+20930 - 0

22558 - 44.64; 

22857 - 51.43;

+22845 - 21.42;

+22853 - 7.64;

+20930 - 0;

4 ALIF, 1 Level + Posterolateral Fusion + Pedicle Screw Fixation - COMPLETE TREATMENT PLAN   22558; +22845; +22853; +20930; 22612; +22840   22558 - anterior lumbar interbody fusion; +22845 - anterior plating if used, do not use for standalone; +22853 - placement of intervertebral device such as PEEK, titanium, use for stand-alone cage with screw or wing fixation, do not use for structural bone allograft, instead use +20931; +20930 - morselized allograft; 22612 is for single level posterolateral lumbar fusion; +22840 - 2 vertebral posterior instrumentation

22558 - 23.53; 

+22845 - 11.94;

+22853 - 4.25; 

+20930 - 0; 

22612 - 23.53; 

+22840 - 12.52

22558 - 44.64; 

+22845 - 21.42;

+22853 - 7.64; 

+20930 - 0; 

22612 - 46.14; 

+22840 - 22.26

8 Laminectomy for excision or evacuation of intraspinal lesion other than neoplasm, extradural; sacral   63268 +69990 Use of microscope Sacral laminectomy(ies) for epidural hematoma, abscess, synovial cyst, etc.

63268 - 20.02;

+69990 - 3.46

63268 - 40.77;

+69990 - 6.43

9 Far Lateral Microdiscectomy   63056     63056 - 21.86 63056 - 43.21
10 I&D of Deep Infection Posterior Spine, Lumbosacral   22015     22015 - 12.64 22015 - 27.14
13 Lumbar - 1 Level revision posterior fusion   22612; 22558; 63047; 20936; 20930; 61783; 20975; 76000-26   20936 is morselized autograft through same fascial incision; 20930 is morselized allograft

22612 - 23.53; 

22558 - 23.53; 

63047 - 15.37; 

20936 - 0; 

20930 - 0; 

61783 - 3.75; 

20975 - 2.60; 

76000-26 - 0.17

22612 - 46.14; 

22558 - 44.64; 

63047 - 32.06; 

20936 - 0; 

20930 - 0; 

61783 - 6.83; 

20975 - 5.16; 

76000-26 - 0.25

14 Lumbar Corpectomies, Cage and Plate Fusion, 2 Vertebrae s- COMPLETE TREATMENT PLAN   63090; +63091; 22558; +22585; +22845; +22854; +20936; +20930   63090 - lumbar corpectomy; 63091 - additional vertebrae corpectomy; 22558 - one level anterolateral fusion; +22585 - additional level of anterolateral fusion; +22845 - three vertebrae plating; +22854 - corpectomy cage placement; 20936 - morselized autograft through same fascial incision; 20930 - morselized allograft

63090 - 30.93;

+63091 - 3.03; 

22558 - 23.53;

+22585 - 5.52;

+22845 - 11.94;

+22854 - 5.50;

+20936 - 0;

+20930 - 0

63090 - 56.83;

+63091 - 5.18; 

22558 - 44.64;

+22585 - 9.61;

+22845 - 21.42;

+22854 - 9.89;

+20936 - 0;

+20930 - 0

15 Lumbar Corpectomy, Cage and Plate Fusion, 1 Vertebrae - COMPLETE TREATMENT PLAN   63090; 22558; +22585; +22845; +22854; +20936; +20930   63090 - lumbar corpectomy; 22558 - one level anterolateral fusion; +22585 - additional level of anterolateral fusion; +22845 - three vertebrae plating; +22854 - corpectomy cage placement; 20936 - morselized autograft through same fascial incision; 20930 - morselized allograft

63090 - 30.93; 

22558 - 23.53; 

+22585 - 5.52;

+22845 - 11.94;

+22854 - 5.50;

+20936 - 0;

+20930 - 0

63090 - 56.83; 

22558 - 44.64; 

+22585 - 9.61;

+22845 - 21.42;

+22854 - 9.89;

+20936 - 0;

+20930 - 0

16 Lumbar decompression and posterolateral instrumented fusion, 1 level   22612; 63047+51; +22840   22612 is for single level posterolateral lumbar fusion; 63047 for single level decompression; +22840 - 2 vertebral posterior instrumentation

22612 - 23.53; 

63047+51 - no RVU;

+22840 - 12.52

22612 - 46.14; 

63047+51 - no RVU;

+22840 - 22.26

17 Lumbar decompression and posterolateral instrumented fusion, 2 levels   22612; 22614; 63047; 63048; 22842; 61783; 20937; 20936; 20930   22612 is for single level posterolateral lumbar fusion; 20936 is morselized autograft through same fascial incision; 20930 is morselized allograft; 22842 - 3 to 6 vertebral posterior instrumented fixation

22612 - 23.53; 

22614 - 6.43; 

63047 - 15.37; 

63048 - 3.47; 

22842 - 12.56; 

61783 - 3.75; 

20937 - 2.79;

20936 - 0; 

20930 - 0

22612 - 46.14; 

22614 - 11.47; 

63047 - 32.06; 

63048 - 6.19; 

22842 - 22.35; 

61783 - 6.83; 

20937 - 4.90; 

20936 - 0; 

20930 - 0

18 Lumbar decompression and posterolateral instrumented fusion, 3 levels   22612; 22614 x 2; 63047; 63048; 22842; 61783; 20937; 20936; 20930   22612 is for single level posterolateral lumbar fusion; 20936 is morselized autograft through same fascial incision; 20930 is morselized allograft; 22842 - 3 to 6 vertebral posterior instrumented fixation

22612 - 23.53; 

22614 x 2 - 12.86; 

63047 - 15.37; 

63048 - 3.47; 

22842 - 12.56; 

61783 - 3.75; 

20937 - 2.79;

20936 - 0; 

20930 - 0

22612 - 46.14; 

22614 x 2 - 22.94; 

63047 - 32.06; 

63048 - 6.19; 

22842 - 22.35; 

61783 - 6.83; 

20937 - 4.9; 

20936 - 0; 

20930 - 0

19 Lumbar decompression, posterior interbody and posterolateral instrumented fusion, 1 Level   22633; 22840; 22851; 61783; 20937; 20936; 20930   20936 is morselized autograft through same fascial incision; 20930 is morselized allograft; 22840 - 2 vertebral posterior instrumentation

22633 - 27.75; 

22840 - 12.52; 

22851 - 0; 

61783 - 3.75; 

20937 - 2.79; 

20936 - 0; 

20930 - 0

22633 - 53.96; 

22840 - 22.26; 

22851 - 0; 

61783 - 6.83; 

20937 - 4.9; 

20936 - 0; 

20930 - 0

20 Lumbar decompression, posterior interbody and posterolateral instrumented fusion, 2 Levels   22612; 22614; 22630; 22632; 63047; 63048; 22842; 22851; 61783; 20937; 20936; 20930   22612 is for single level posterolateral lumbar fusion; 20936 is morselized autograft through same fascial incision; 20930 is morselized allograft; 22842 - 3 to 6 vertebral posterior instrumented fixation

22612 - 23.53; 

22614 - 6.43;

22630 - 22.09; 

22632 - 5.22; 

63047 - 15.37; 

63048 - 3.47;

22842 - 12.56; 

22851 - 0; 

61783 - 3.75; 

20937 - 2.79; 

20936 - 0; 

20930 - 0

22612 - 46.14; 

22614 - 11.47; 

22630 - 45.76; 

22632 - 9.43; 

63047 - 32.06; 

63048 - 6.19; 

22842 - 22.35; 

22851 - 0; 

61783 - 6.83; 

20937 - 4.9; 

20936 - 0; 

20930 - 0

21 Lumbar Disc Arthroplasty   22857     22857 - 27.13 22857 - 51.43
22 Lumbar Disc Replacement Surgery   22857     22857 - 27.13 22857 - 51.43
  Lumbar posterior instrumented fusion, 2 levels - COMPLETE TREATMENT PLAN   22612; +22614; +22842 +61783; +20937; +20936; +20930 22612 - single level posterior lumbar fusion, e.g. L1/2; +22614 - additional level posterior lumbar fusion; +22842 - 3 to 6 vertebral posterior instrumented fixation; +20937 - morselized autograft through separate fascial incision, e.g. iliac creast bone graft; +20936 is morselized autograft through same fascial incision, e.g. spinous process, lamina; +20930 is morselized allograft, e.g. DBM, Infuse, BMP

22612 - 23.53; 

+22614 - 6.43;

+22842 - 12.56;

+61783 - 3.75;

+20937 - 2.79; 

+20936 - 0; 

+20930 - 0

22612 - 46.14; 

+22614 - 11.47;

+22842 - 22.35;

+61783 - 6.83;

+20937 - 4.90; 

+20936 - 0; 

+20930 - 0

23 Lumbar posterior instrumented fusion, 3 levels  - COMPLETE TREATMENT PLAN   22612; +22614 x 2; +22842 +61783; +20937; +20936; +20930 22612 - single level posterior lumbar fusion, e.g. L1/2; +22614 - additional level posterior lumbar fusion; +22842 - 3 to 6 vertebral posterior instrumented fixation; +20937 - morselized autograft through separate fascial incision, e.g. iliac creast bone graft; +20936 is morselized autograft through same fascial incision, e.g. spinous process, lamina; +20930 is morselized allograft, e.g. DBM, Infuse, BMP

22612 - 23.53; 

+22614 x 2 - 12.86;

+22842 - 12.56;

+61783 - 3.75;

+20937 - 2.79; 

+20936 - 0; 

+20930 - 0

22612 - 46.14; 

+22614 x 2 - 22.94;

+22842 - 22.35;

+61783 - 6.83;

+20937 - 4.90

+20936 - 0;

+20930 - 0

  Lumbar posterior instrumented fusion, 4 levels - COMPLETE TREATMENT PLAN   22612; +22614 x 3; +22842 +61783; +20937; +20936; +20930 22612 - single level posterior lumbar fusion, e.g. L1/2; +22614 - additional level posterior lumbar fusion; +22842 - 3 to 6 vertebral posterior instrumented fixation; +20937 - morselized autograft through separate fascial incision, e.g. iliac creast bone graft; +20936 is morselized autograft through same fascial incision, e.g. spinous process, lamina; +20930 is morselized allograft, e.g. DBM, Infuse, BMP

22612 - 23.53; 

+22614 x 3 - 19.29;

+22842 - 12.56;

+61783 - 3.75;

+20937 - 2.79; 

+20936 - 0; 

+20930 - 0

22612 - 46.14; 

+22614 x 3 - 34.41;

+22842 - 22.35;

+61783 - 6.83;

+20937 - 4.9;

+20936 - 0;

+20930 - 0

24 Lumbar posterior instrumented fusion, 5 levels  - COMPLETE TREATMENT PLAN   22612; +22614 x 4; +22842 +61783; +20937; +20936; +20930 22612 - single level posterior lumbar fusion, e.g. L1/2; +22614 - additional level posterior lumbar fusion; +22842 - 3 to 6 vertebral posterior instrumented fixation; +20937 - morselized autograft through separate fascial incision, e.g. iliac creast bone graft; +20936 is morselized autograft through same fascial incision, e.g. spinous process, lamina; +20930 is morselized allograft, e.g. DBM, Infuse, BMP

22612 - 23.53; 

+22614 x 4 - 25.72;

+22842 - 12.56;

+61783 - 3.75;

+20937 - 2.79; 

+20936 - 0; 

+20930 - 0

22612 - 46.14; 

+22614 x 4 - 45.88;

+22842 - 22.35;

+61783 - 6.83;

+20937 - 4.9;

+20936 - 0;

+20930 - 0

  Lumbar posterior instrumented fusion, 7 levels - COMPLETE TREATMENT PLAN   22612; +22614 x 6; +22843 +61783; +20937; +20936; +20930 22612 - single level posterior lumbar fusion, e.g. L1/2; +22614 - additional level posterior lumbar fusion; +22843 - 7 to 12 vertebral posterior instrumented fixation; +20937 - morselized autograft through separate fascial incision, e.g. iliac creast bone graft; +20936 is morselized autograft through same fascial incision, e.g. spinous process, lamina; +20930 is morselized allograft, e.g. DBM, Infuse, BMP

22612 - 23.53; 

+22614 x 6 - 38.58;

+61783 - 3.75;

+20937 - 2.79; 

+20936 - 0; 

+20930 - 0

+22843 - 13.44

22612 - 46.14; 

+22614 x 6 - 68.82;

+61783 - 6.83;

+20937 - 4.9;

+20936 - 0;

+20930 - 0;

+22843 - 23.91

  Lumbar posterior instrumented fusion, 8 levels - COMPLETE TREATMENT PLAN   22612; +22614 x 7; +22843 +61783; +20937; +20936; +20930 22612 - single level posterior lumbar fusion, e.g. L1/2; +22614 - additional level posterior lumbar fusion; +22843 - 7 to 12 vertebral posterior instrumented fixation; +20937 - morselized autograft through separate fascial incision, e.g. iliac creast bone graft; +20936 is morselized autograft through same fascial incision, e.g. spinous process, lamina; +20930 is morselized allograft, e.g. DBM, Infuse, BMP

22612 - 23.53; 

+22614 x 7 - 45.01;

+61783 - 3.75;

+20937 - 2.79; 

+20936 - 0; 

+20930 - 0

+22843 - 13.44

22612 - 46.14; 

+22614 x 7 - 80.29

+61783 - 6.83;

+20937 - 4.9;

+20936 - 0;

+20930 - 0;

+22843 - 23.91

  Lumbar posterior instrumented fusion, 6 levels - COMPLETE TREATMENT PLAN   22612; +22614 x 5; +22842 +61783; +20937; +20936; +20930 22612 - single level posterior lumbar fusion, e.g. L1/2; +22614 - additional level posterior lumbar fusion; +22842 - 3 to 6 vertebral posterior instrumented fixation; +20937 - morselized autograft through separate fascial incision, e.g. iliac creast bone graft; +20936 is morselized autograft through same fascial incision, e.g. spinous process, lamina; +20930 is morselized allograft, e.g. DBM, Infuse, BMP

22612 - 23.53; 

+22614 x 5 - 32.15;

+22842 - 12.56

+61783 - 3.75;

+20937 - 2.79; 

+20936 - 0; 

+20930 - 0

22612 - 46.14; 

+22614 x 5 - 57.35;

+22842 - 22.35;

+61783 - 6.83;

+20937 - 4.9;

+20936 - 0;

+20930 - 0

26 Lumbar laminectomies without facetectomies, foraminotomies, or discectomies, greater than 2 levels   63017   Can be used for laminotomies as well 63017 - 17.33 63017 - 36.67
27 Lumbar laminectomy (ies) without foraminotomies, facectectomies, or discectomies, 1 level or 2 levels   63005   Can be used for laminotomies as well 63005 - 16.43 63005 - 34.45
28 Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s], [eg, spinal or lateral recess stenosis]), single vertebral segment; lumbar   63047 +63048 - additional level Lumbar laminectomy with facetectomies and foraminotomies, 1 level; can be unilateral or bilateral; can be used for laminotomies as well

63047 - 15.37; 

+63048 - 3.47

63047 - 32.06; 

+63048 - 6.19

29 Lumbar posterior instrumented fusion, 9 levels - COMPLETE TREATMENT PLAN   22612; +22614 x 8; +22843 +61783; +20937; +20936; +20930 22612 - single level posterior lumbar fusion, e.g. L1/2; +22614 - additional level posterior lumbar fusion; +22843 - 7 to 12 vertebral posterior instrumented fixation; +20937 - morselized autograft through separate fascial incision, e.g. iliac creast bone graft; +20936 is morselized autograft through same fascial incision, e.g. spinous process, lamina; +20930 is morselized allograft, e.g. DBM, Infuse, BMP; 

22612 - 23.53; 

+22614 x 8 - 51.44;

+61783 - 3.75;

+20937 - 2.79; 

+20936 - 0; 

+20930 - 0

+22843 - 13.44

22612 - 46.14; 

+22614 x 8 - 91.76;

+61783 - 6.83;

+20937 - 4.9;

+20936 - 0;

+20930 - 0;

+22843 - 23.91

30 Lumbar posterior instrumented fusion, 1 level  - COMPLETE TREATMENT PLAN   22612; +22840 +61783; +20937; +20936; +20930 22612 - single level posterior lumbar fusion, e.g. L1/2; +22840 - 2 vertebral posterior instrumentation; +20937 - morselized autograft through separate fascial incision, e.g. iliac creast bone graft; +20936 is morselized autograft through same fascial incision, e.g. spinous process, lamina; +20930 is morselized allograft, e.g. DBM, Infuse, BMP

22612 - 23.53;

+22840 - 12.52; 

+61783 - 3.75;

+20937 - 2.79; 

+20936 - 0; 

+20930 - 0

22612 - 46.14;

+22840 - 22.26; 

+61783 - 6.83;

+20937 - 4.9;

+20936 - 0;

+20930 - 0

31 Microdiscectomy   63030; 69990    

63030 - 13.18; 

69990 - 3.46

63030 - 28.2; 

69990 - 6.43

32 Arthrodesis, combined posterior or posterolateral technique with posterior interbody technique including laminectomy and/or discectomy sufficient to prepare interspace (other than for decompression), single interspace and segment; lumbar   22633 +22634 22558 - anterior lumbar interbody fusion; +22845 - anterior plating if used, do not use for standalone; +22853 - placement of intervertebral device such as PEEK, titanium, use for stand-alone cage with screw or wing fixation, do not use for str

22633 - 27.75;

+22634 - 8.16

22633 - 53.96;

+22634 - 14.55

33 PLIF or TLIF - 1 level WITH posterolateral fusion, COMPLETE TREATMENT PLAN  

22633; 63047-59; +22840;
+22853

+61783 - use of neuronavigation, e.g. Brainlab, Stealth; +69990 - use of microscope; +20930 - morselized allograft; +20936 - morselized autograft through same fascial incision; +20937: moreselized autograft through separate fascial incision 22633 - PLIF or TLIF with posterolateral fusion; 63047-59 - decompression; +22840 - 2 vertebra instrumented fixation; +22853 - PLIF or TLIF cage

22633 - 27.75; 

63047-59 - 15.37; 

+22840 - 12.52;

+22853 - 4.25; 

+61783 - 3.75;

+20937 - 2.79; 

+20936 - 0; 

+20930 - 0

+20937 - 2.79

22633 - 53.96; 

63047-59 - 32.06; 

+22840 - 22.26;

+22853 - 7.64; 

+61783 - 6.83;

+69990 - 6.43; 

+20930 - 0; 

+20936 - 0; 

+20937 - 4.90

34 PLIF or TLIF - 2 levels WITH posterolateral fusion, COMPLETE TREATMENT PLAN  

22633; +22634; 63047-59; +63048; +22842;
+22853 x 2

+20930 - morselized allograft; +20936 - morselized autograft through same fascial incision; +20937: moreselized autograft through separate fascial incision; +69990 - use of microscope; +61783 - use of neuronavigation, e.g. Brainlab, Stealth 22633 - PLIF or TLIF with posterolateral fusion; +22634 - additional level of PLIF or TLIF;  63047-59 - decompression; +63048 for additional level of decompression; +22842 - 3 vertebra instrumented fixation; +22853 - PLIF or TLIF cage

22633 - 27.75;

+22634 - 8.16; 

63047-59 - 15.37;

+63048 - 3.47;

+22842 - 12.56;

+22853 x 2 - 8.50;

+20930 - 0; 

+20936 - 0; 

+20937 - 2.79; 

+69990 - 3.46; 

+61783 - 3.75

22633 - 53.96;

+22634 - 14.55; 

63047-59 - 32.06;

+63048 - 6.19;

+22842 - 22.35;

+22853 x 2 - 15.28;

+20930 - 0; 

+20936 - 0; 

+20937 - 4.9; 

+69990 - 6.43; 

+61783 - 6.83

  PLIF or TLIF - 1 level WITHOUT posterolateral fusion, COMPLETE TREATMENT PLAN  

22630; 63047-59; +22840;
+22853

+20930 - morselized allograft; +20936 - morselized autograft through same fascial incision; +20937: moreselized autograft through separate fascial incision; +69990 - use of microscope; +61783 - use of neuronavigation, e.g. Brainlab, Stealth 22630 - PLIF or TLIF withOUT posterolateral fusion; 63047-59 - decompression; +22840 - 2 vertebra instrumented fixation; +22853 - PLIF or TLIF cage

22630 - 22.09; 

63047-59 - 15.37;

+22840 - 12.52;

+22853 - 4.25;

+20930 - 0; 

+20936 - 0; 

+20937 - 2.79; 

+69990 - 3.46; 

+61783 - 3.75

22630 - 45.76; 

63047-59 - 32.06;

+22840 - 22.26;

+22853 - 7.64;

+20930 - 0; 

+20936 - 0; 

+20937 - 4.9; 

+69990 - 6.43; 

+61783 - 6.83

  PLIF or TLIF - 2 levelS WITHOUT posterolateral fusion, COMPLETE TREATMENT PLAN  

22630; +22632; 63047-59; +22842;
+22853 x 2

+20930 - morselized allograft; +20936 - morselized autograft through same fascial incision; +20937: moreselized autograft through separate fascial incision; +69990 - use of microscope; +61783 - use of neuronavigation, e.g. Brainlab, Stealth 22630 - PLIF or TLIF withOUT posterolateral fusion; +22632 - additional level of PLIF or TLIF;  63047-59 - decompression; +63048 for additional level of decompression; +22842 - 3 vertebra instrumented fixation; +22853 - PLIF or TLIF cage

22630 - 22.09;

+22632 - 5.22;

63047-59 - 15.37;

+22842 - 12.56;

+22853 x 2 - 8.50;

+20930 - 0; 

+20936 - 0; 

+20937 - 2.79; 

+69990 - 3.46; 

+61783 - 3.75

22630 - 45.76; 

+22632 - 9.43

63047-59 - 32.06;

+22842 - 22.35;

+22853 x 2 - 15.28;

+20930 - 0; 

+20936 - 0; 

+20937 - 4.9; 

+69990 - 6.43; 

+61783 - 6.83

35 Redo Lumbar Laminotomies, Mesial Facetectomies, and Foraminotomies; 2 Levels   63042, +63044   +63044 is code for additional level

63042 - 18.76;

+63044 - 0

63042 - 37.67;

+63044 - 0

36 Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc, reexploration, single interspace; lumbar   63042 +69990 Use of microscope Redo lumbar microdiscectomy

63042 - 18.76; 

+69990 - 3.46

63042 - 37.67; 

+69990 - 6.43;

38 Removal of anterior spinal instrumentation   22855     22855 - 15.86 22855 - 32.19
39 Repair of CSF Leak with Laminectomy   63709   Cannot code with laminectomy codes 63709 - 15.65 63709 - 32.02
40 Revision of spinal instrumentation   22849     22849 - 19.17 22849 - 37.75
41 Laminectomy for excision or evacuation of intraspinal lesion other than neoplasm, extradural; lumbar   63267 +69990 Use of microscope Lumbar laminectomy(ies) for epidural hematoma, abscess, synovial cyst, etc.

63267 - 19.45; 

+69990 - 3.46

63267 - 39.92; 

+69990 - 6.43

42 Surgery - L5/S1 AxiaLIF   22558; 22840; 22845; 76000-26; 20930; 20936   20936 is morselized autograft through same fascial incision; 20930 is morselized allograft; +22840 - 2 vertebral posterior instrumentation

22558 - 23.53; 

22840 - 12.52; 

22845 - 11.94; 

76000-26 - 0.17; 

20930 - 0;

20936 - 0

22558 - 44.64; 

22840 - 22.26; 

22845 - 21.42; 

76000-26 - 0.25; 

20930 - 0;

20936 - 0

48 X-STOP, 2 Level   0171T#; 0172T#    

0171T# - 0; 

0172T# - 0

0171T# - 0; 

0172T# - 0

49 Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression); lumbar   22558 +22585 for each additional level; +22845 - anterior plating 2 - 3 vertebral levels; +22853 is used for a device, with fusion, with or without integrated anterior fixation which should be reported for each level; +20937 morselized autograft through separate fascial incision, e.g. iliac crest bone graft; +20936 morselized autograft through same fasical inicsion, e.g. osteophyte from vertebral body being fused; +20930 report only once for all moreselized allograft, e.g. DBM, Osteocell, Trinity, Infuse, BMP ALIF, Anterior Lumbar Interbody Fusion, XLIF, DLIF, Extreme Lateral Lumbar Interbody Fusion

22558 - 23.53;

+22845 - 11.94;

+22853 - 4.25;

+20937 - 2.79;

+20936 - 0;

+20930 - 0

22558 - 44.64;

+22845 - 21.42;

+22853 - 7.64;

+20937 - 4.90;

+20936 - 0;

+20930 - 0

50 Osteotomy of spine, posterior or posterolateral approach, 1 vertebral segment; lumbar   22214  +22216 is for additional levels of osteotomies 22214 can be used for Smith-Petersen or Ponte osteotomy; it is a primary code and -51 modifier should be used as other higher value codes would typically precede this code

22214 - 21.02;

+22216 - 6.03

22214 - 43.17;

+22216 - 10.62

52 Laminectomy, with release of tethered spinal cord, lumbar   63200     63200 - 21.44 63200 - 44.99
53 Laminectomy and Removal of Lesion other than Herniated Disc   63295     63295 - 5.25 63295 - 9.82 
54 Laminectomy for excision of intraspinal lesion other than neoplasm, intradural, lumbar   63272     63272 - 27.50 63272 - 55.20
  Vertebral corpectomy at least 1/3 of vertebra via trans- or retroperitoneal approach for decompression   63090     63090 - 30.93 63090 - 56.83
  Laminectomy for biopsy/excision of intraspinal neoplasm; extradural, lumbar   63277 +69990 Use of microscope Lumbar Laminectomy (ies) for schwannoma

63277 - 22.39; 

+69990 - 3.46

63277 - 45.25; 

+69990 - 6.43

  Spinal puncture, therapeutic, for drainage of cerebrospinal fluid (by needle or catheter)   62272   Spinal Tap, Lumbar Drain Placement 62272 - 1.35 62272 - 2.43
 

Application of intervertebral biomechanical device(s) (eg, synthetic cage(s), methylmethacrylate) to vertebral defect or interspace (list separately in addition to code for primary procedure)

  +22851   This code as of 1/1/17 will no longer be used by Medicare. Some other payers may continue to use this code. Use +22853 (interbody cage), +22854 (corpectomy cage), +22859 (any cage without fusion) instead.  

+22851 - No RVU;

+22853 - 4.25

+22851 - No RVU;

+22853 - 7.64

 

  Insertion of interbody biomechanical device(s) (eg, synthetic cage, mesh) with integral anterior instrumentation for device anchoring (eg, screws, flanges), when performed, to intervertebral disc space in conjunction with interbody arthrodesis, each interspace (List separately in addition to code for primary procedure)   +22853   Used for a device, with fusion, with or without integrated anterior fixation +22853 - 4.25 +22853 - 7.64
 

Insertion of intervertebral biomechanical device(s) (eg, synthetic cage, mesh) with integral anterior instrumentation for device anchoring (eg, screws, flanges), when performed, to vertebral corpectomy(ies) (vertebral body resection, partial or complete) defect, in conjunction with interbody arthrodesis, each contiguous defect (List separately in addition to code for primary procedure)

  +22854   Used for a device to fill a corpectomy defect, with fusion, with or without integrated anterior fixation +22854 - 5.50 +22854 - 9.89
 

Insertion of intervertebral biomechanical device(s) (eg, synthetic cage, mesh, methylmethacrylate) to intervertebral disc space or vertebral body defect without interbody arthrodesis, each contiguous defect (List separately in addition to code for primary procedure)

  +22859   Used for interbody device insertion without fusion +22859 - 5.50 +22859 - 9.89
 

Posterior non-segmental instrumentation (eg, Harrington rod technique, pedicle fixation across 1 interspace, atlantoaxial transarticular screw fixation, sublaminar wiring at C1, facet screw fixation)

  +22840   2 vertebral posterior instrumented fixation; List separately in addition to code for primary procedure; Count vertebrae and not levels. +22840 - 12.52 +22840 - 22.26
 

Posterior segmental instrumentation (eg, pedicle fixation, dual rods with multiple hooks and sublaminar wires); 3 to 6 vertebral segments

  +22842  

3 to 6 vertebral posterior instrumented fixation; List separately in addition to code for primary procedure; Count vertebrae and not levels.

+22842 - 12.56 +22842 - 22.35
 

Posterior segmental instrumentation (eg, pedicle fixation, dual rods with multiple hooks and sublaminar wires); 7 to 12 vertebral segments

  +22843   7 to 12 vertebral posterior instrumented fixation; List separately in addition to code for primary procedure; Count vertebrae and not levels. +22843 - 13.44

+22843 - 23.91

 

Arthrodesis, posterior interbody technique, including laminectomy and/or discectomy to prepare interspace (other than for decompression), single interspace; lumbar

  22630 +22632 Posterior Lumbar Interbody Fusion (PLIF) or Transforaminal Interbody Fusion (TLIF) WITHOUT posterolateral fusion. +22632 - each additional interspace. Use for Minimally Invasive (MIS) TLIF. Do not add 22612 or 22614 if posterolateral fusion was done. Instead use 22633. May use laminectomy code 63047 if decompression was done  beyond needed for the interbody fusion.

22630 - 22.09;

+22632 - 5.22

22630 - 45.76;

+22632 - 9.43

 

ALIF, 2 Levels COMPLETE TREATMENT PLAN

  22558, +22585, +22845, +22853 x 2, +20930   22558 - anterior lumbar interbody fusion; +22845 - anterior plating if used, do not use for standalone; +22585 - anterior plating if used, do not use for standalone; +22853 x 2 - placement of intervertebral device such as PEEK, titanium, use for stand-alone cage with screw or wing fixation, do not use for structural bone allograft, instead use +20931; +20930 - morselized allograft

22558 - 23.53;

+22585 - 5.52;

+22845 - 11.94;

+22853 x 2 - 8.50;

+20930 - 0

22558 - 44.64;

+22585 - 9.61;

+22845 - 21.42;

+22853 x 2 - 15.28;

+20930 - 0

 

Repair of dural/cerebrospinal fluid leak, not requiring laminectomy

  63707 +69990 Repair of CSF Leak without Laminectomy 63707 - 12.65;
+69990 - 3.46

63707 - 26.77;
+69990 - 6.43

 

Repair of dural/cerebrospinal fluid leak or pseudomeningocele, with laminectomy

  63709 +69990 Repair of CSF Leak with Laminectomy 63709 - 15.65;
+69990 - 3.46

63709 - 32.02;
+69990 - 6.43

 

Percutaneous vertebroplasty (bone biopsy included when performed), 1 vertebral body, unilateral or bilateral injection, inclusive of all imaging guidance; cervicothoracic

  22510 +22512 +22512 - each additional vertebral body

22510 - 7.90;

+22512 - 4.00

22510 - 12.63;

+22512 - 6.07

 

Percutaneous vertebral augmentation, including cavity creation (fracture reduction and bone biopsy included when performed) using mechanical device (eg, kyphoplasty), 1 vertebral body, unilateral or bilateral cannulation, inclusive of all imaging guidance; lumbar

  22514 +22515 +22515 - each additional vertebral body; Kphoplasty

22514 - 7.99;

+22515 - 4.00

22514 - 14.06;

+22515 -6.54

 

Insertion of interlaminar/interspinous process stabilization/distraction device, without fusion, including image guidance when performed, with open decompression, lumbar; single level

  22867 +22868 22867 - Coflex placement with laminotomy and without fusion; +22868 - each additional level

22867 - 13.50;

+22868 - 4.00

22867 - 28.55;

+22868 - 7.14

 

Insertion of interlaminar/interspinous process stabilization/distraction device, without open decompression or fusion, including image guidance when performed, lumbar; single level

  22869 +22870 22869 - Coflex placement without laminotomy and without fusion; +22870 - each additional level

22869 - 7.03;

+22870 - 2.34

22869 - 15.70;

+22870 - 4.16

 

Biopsy, vertebral body, open; lumbar or cervical

  20251     20251 - 5.72

20251 - 12.26

 

ALIF, 1 Level - COMPLETE TREATMENT PLAN

  22558; +22845; +22851; +20930   22558 - anterior lumbar interbody fusion; +22845 - anterior plating if used, do not use for standalone; +22853 - placement of intervertebral device such as PEEK, titanium, use for stand-alone cage with screw or wing fixation, do not use for structural bone allograft, instead use +20931; +20930 - morselized allograft

22558 - 23.53;

+22845 - 11.94;

+22851 - No RVU;

+20930 - 0;

+22853 - 4.25

22558 - 44.64;

+22845 - 21.42;

+22851 - No RVU;

+20930 - 0;

+22853 - 7.64;

 

Arthrodesis, posterior or posterolateral technique, single level; lumbar (with lateral transverse technique, when performed)

  22612 +22614  

22612 - 23.53;

+22614 - 6.43

22612 - 46.14;

+22614 - 11.47

 

Spinal puncture, lumbar, diagnostic modifier 53 (Discontinued procedure)

  62270     62270 - 1.47

62270 - 2.25

 

MOVE ALIF, 1 Level - COMPLETE TREATMENT PLAN

PLACE ALIF, 1 Level - COMPLETE TREATMENT PLAN 22558; 22857; +22845; +22853; +20930    

22558 - 23.53;

22857 - 27.13;

+22845 - 11.94;

+22853 - 4.25;

+20930 - 0

22558 - 44.64;

22857 - 51.43;

+22845 - 21.42;

+22853 - 7.64;

+20930 - 0